The socioeconomic burden of chronic lung disease in low-resource settings across the globe – an observational FRESH AIR study

Abstract Background Low-resource settings are disproportionally burdened by chronic lung disease due to early childhood disadvantages and indoor/outdoor air pollution. However, data on the socioeconomic impact of respiratory diseases in these settings are largely lacking. Therefore, we aimed to estimate the chronic lung disease-related socioeconomic burden in diverse low-resource settings across the globe. To inform governmental and health policy, we focused on work productivity and activity impairment and its modifiable clinical and environmental risk factors. Methods We performed a cross-sectional, observational FRESH AIR study in Uganda, Vietnam, Kyrgyzstan, and Greece. We assessed the chronic lung disease-related socioeconomic burden using validated questionnaires among spirometry-diagnosed COPD and/or asthma patients (total N = 1040). Predictors for a higher burden were studied using multivariable linear regression models including demographics (e.g. age, gender), health parameters (breathlessness, comorbidities), and risk factors for chronic lung disease (smoking, solid fuel use). We applied identical models per country, which we subsequently meta-analyzed. Results Employed patients reported a median [IQR] overall work impairment due to chronic lung disease of 30% [1.8–51.7] and decreased productivity (presenteeism) of 20.0% [0.0–40.0]. Remarkably, work time missed (absenteeism) was 0.0% [0.0–16.7]. The total population reported 40.0% [20.0–60.0] impairment in daily activities. Breathlessness severity (MRC-scale) (B = 8.92, 95%CI = 7.47–10.36), smoking (B = 5.97, 95%CI = 1.73–10.22), and solid fuel use (B = 3.94, 95%CI = 0.56–7.31) were potentially modifiable risk factors for impairment. Conclusions In low-resource settings, chronic lung disease-related absenteeism is relatively low compared to the substantial presenteeism and activity impairment. Possibly, given the lack of social security systems, relatively few people take days off work at the expense of decreased productivity. Breathlessness (MRC-score), smoking, and solid fuel use are potentially modifiable predictors for higher impairment. Results warrant increased awareness, preventive actions and clinical management of lung diseases in low-resource settings from health policymakers and healthcare workers.

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COMPARISON OF MORTALITY RELATED RISK FACTORS OF COVID-19 AND SARI DEATH DURING THE PEAK OF PANDEMIC IN A TERTIARY CARE CENTRE.

10.36106/gjra/2712341 ◽

2021 ◽

pp. 136-139

Author(s):

K. Anbananthan ◽

A. Manimaran ◽

A. Ramasamy ◽

S. A. Natesh ◽

AnuSree. S. C

Keyword(s):

Risk Factors ◽

Liver Disease ◽

Cerebrovascular Disease ◽

Lung Disease ◽

Chronic Lung Disease ◽

Poor Prognosis ◽

Severe Acute Respiratory Infection ◽

Viral Infectious Disease ◽

Study Population ◽

D Dimer

Background: COVID-19 is a viral infectious disease caused by the SARS CoV-2 virus which causes severe respiratory distress in a certain number of patients with specic risk factors. This study compares the mortality risk factors of COVID 19 and Severe Acute Respiratory Infection (SARI) deaths and also determines the most likely causes that lead to such a poor prognosis Objectives: To evaluate the risk factors of COVID 19 and SARI causing mortality. To compare the most likely risk factors that lead to such a poor prognosis Materials And Methods: This was a Cross sectional study done on 190 patients which includes all cases of covid 19 and SARI deaths within the peak of pandemic period (August 2020). Patient datas were collected from MRD registry at Thanjavur Medical College. Results: Among the study population of 190, age distribution of the patients died due to covid-19 was minimum 26 years to maximum 89 years and mean age of 61years. Most commonly affected were in the age around 60years. Distribution of male is around 72.1%.This study showed 47.9% were covid positive and 42.1% were suspected based on CT chest nding and clinical features. Around 84.7% were diabetic and 56.3% were hypertensive. There is no signicant difference between the exposure rate of diabetes, hypertension, CKD, chronic lung disease, cerebrovascular disease, liver disease, malignancy among covid and SARI group. Among these study population 94.7% had elevated d-dimer level. Conclusion: This study showed various comorbidities, complications, and demographic variables including diabetes, hypertension, chronic kidney disease,, chronic lung disease,liver disease, Cerebrovascular disease, cancer, increased D-dimer, male gender, older age(>50), smoking, and obesity are clinical risk factors for a fatal outcome associated with COVID 19.

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Risk Factors of Pulmonary Hypertension in Preterm Infants with Chronic Lung Disease

Neonatal Medicine ◽

10.5385/nm.2013.20.1.75 ◽

2013 ◽

Vol 20 (1) ◽

pp. 75 ◽

Cited By ~ 1

Author(s):

Jeong Jin Ra ◽

Soon Min Lee ◽

Ho Sun Eun ◽

Min Soo Park ◽

Kook In Park ◽

...

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Lung Disease ◽

Preterm Infants ◽

Chronic Lung Disease

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Inherited Risk Factors for Chronic Lung Disease

CHEST Journal ◽

10.1378/chest.77.2_supplement.255 ◽

1980 ◽

Vol 77 (2) ◽

pp. 255-257 ◽

Cited By ~ 5

Author(s):

R. Madison ◽

R. Zelman ◽

Charles Mittman

Keyword(s):

Risk Factors ◽

Lung Disease ◽

Chronic Lung Disease ◽

Inherited Risk

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Inherited Risk Factors for Chronic Lung Disease

CHEST Journal ◽

10.1378/chest.77.2.255 ◽

1980 ◽

Vol 77 (2) ◽

pp. 255-257 ◽

Cited By ~ 4

Author(s):

R. Madison ◽

R. Zelman ◽

Charles Mittman

Keyword(s):

Risk Factors ◽

Lung Disease ◽

Chronic Lung Disease ◽

Inherited Risk

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Development of an educational intervention to reduce the burden of adult chronic lung disease in rural India: Inputs from a qualitative study

PLoS ONE ◽

10.1371/journal.pone.0254534 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0254534

Author(s):

Biswajit Paul ◽

Rita Isaac ◽

Hemalatha R. ◽

Paul Jebaraj ◽

Muthathal S. ◽

...

Keyword(s):

Risk Factors ◽

Health Care ◽

Lung Disease ◽

Health Behaviour ◽

Chronic Lung Disease ◽

Lived Experiences ◽

Health Behaviours ◽

Care Providers ◽

Usual Practice ◽

Factors Influencing

Background Chronic respiratory diseases (CRDs) are major causes of mortality and morbidity worldwide with a substantial burden of the disease being borne by the low and middle income countries (LMICs). Interventions to change health behaviour which aim to improve the quality of life and reduce disease burden due to CRD require knowledge of the problem and factors influencing such behaviour. Our study sought to appreciate the lived experiences of people with CRD, their understanding of the disease and its risk factors, and usual practice of health behaviour in a rural low-literate community in southern India. Methods Qualitative data were collected between September and December 2018 through eight focus group discussions (FGDs), five in-depth interviews and four key-informant interviews from patients and community members. Community engagement was undertaken prior to the study and all interviews and discussions were recorded with permission. Inductive coding was used to thematically analyse the results. Results Major themes included understanding of chronic lung disease, health behaviours, lived experiences with the disease and social norms, attitudes and other factors influencing health behaviour. Discussion Poor understanding of CRDs and their risk factors affect health seeking behaviour and/or health practices. Stigma associated with the disease and related health behaviours (e.g. inhaler use) creates emotional challenges and mental health problems, besides influencing health behaviour. However barriers can be circumvented by increasing community awareness; communication and connection with the community through community based health care providers can turn challenges into opportunities for better health care.

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Risk factors for pneumonia in infants and young children and the role of solid fuel for cooking: a case-control study

Epidemiology and Infection ◽

10.1017/s0950268802006817 ◽

2002 ◽

Vol 129 (1) ◽

pp. 65-71 ◽

Cited By ~ 46

Author(s):

D. MAHALANABIS ◽

S. GUPTA ◽

D. PAUL ◽

A. GUPTA ◽

M. LAHIRI ◽

...

Keyword(s):

Risk Factors ◽

Solid Fuel ◽

Case Control Study ◽

Population Attributable Risk ◽

Case Control ◽

Policy Implications ◽

Fuel Use ◽

Early Action ◽

History Of ◽

Control Study

We evaluated the risk factors for childhood pneumonia with particular reference to indoor air-pollution associated with solid fuel use for cooking (e.g. coal, wood, dung), using a case-control study in a children's hospital in Calcutta. Cases were 127 children aged 2–35 months of either sex admitted with pneumonia and controls were 135 children attending their immunization clinic. Solid fuel use (odds ratio = 3.97, CI = 2.00–7.88), history of asthma in the child (OR = 5.49, CI = 2.37–12.74), poor economic status indicator (OR = 4.95, CI = 2.38 to 10.28), keeping large animals (OR = 6.03, CI = 1.13–32.27) were associated with high risk of pneumonia after adjusting for confounding (logistic regression analysis). Nearly 80% of people in India use such smoke producing fuel and the population attributable risk would be very high. This finding has important health policy implications. Furthermore, history of asthma is a useful prognostic indicator for early action for prevention of severe pneumonia.

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